BackgroundVaginal delivery after previous one cesarean section for a non recurring indication has been described by several authors as safe and having a success rate of 60–80%. Hence many centers are offering VBAC for candidates leaving the century old dictum of once cesarean always cesarean. But predicting success of VBAC after trial of labor (TOL) is still a difficult task due to the lack of a validated prediction tool. Studies on predictors of success are few and most of them conducted in developed countries and difficult to generalize. Therefore assessing factors associated with successful VBAC is very important to for counseling mothers while offering VBAC. The aim of this study was to assess factors associated with successful VBAC in three teaching Hospitals in Addis Ababa Ethiopia.MethodsA case control study was conducted to compare the factors associated with successful VBAC in teaching hospitals in Addis Ababa in one year period. The cases were those successfully delivered vaginally and the controls were those with failed VBAC and delivered by caesarean section. The sample size of the cases was 101vaginal deliveries and the controls were 103 failed VBAC patients which made the case to control ratio of 1:1.ResultIn this study independent factors determining successful VBAC were, history of successful VBAC in the past, rupture of membrane at admission, and cervical dilatation of more than 3cm at admission. Presence of meconium, malposition and history of stillbirth were associated with failed VBAC. Factors like maternal age, past caesarean indications, inter delivery interval, and birth weight were not found to be significant determinants of success. The most common reason for repeat cesarean section for after trial of labor was labour dysfunction because of absence of a policy for augmentation on a scarred uterus in these hospitals.ConclusionIt is possible to prepare a decision tool on the success of VBAC by taking important past and present obstetric and reproductive performance history as predictor.

BackgroundSatisfaction during intrapartum care is the most influential attribute on maternal health service return behaviors and utilization. Measuring satisfaction of women with intrapartum care helps to address the problems and improves the quality of delivery services. The aim of this study is to assess women’s level of satisfaction during intrapartum care.MethodA hospital based, analytic, cross sectional study was conducted at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa Ethiopia, from May to June 2015. Data collectors administered a structured and pretested questionnaire to collect data and then analyzed it using SPSS version 20.0 software.Binary logistic regression was used to identify factors associated with women’s intrapartum care satisfaction.ResultA total of 394 women of mean age 25.98 years with a standard deviation of ±4.72were included in the study. Only 19% of the women were satisfied with the intrapartum care they received. The variables which were significantly associated with satisfaction of intrapartum care were; opportunity to talk Adjusted Odds Ratio (AOR) (95% CI) 2.44 (1.12, 5.29); Pain Management AOR (95% CI) 3.37 (1.83, 6.21); Short Length of Time Taken for Admission After Seen by Health Professionals AOR (95% CI)0 .97 (0.93, 0.99), and Short Length of Stay in the Hospital AOR (95% CI) 0.91 (0.87, 0.96).ConclusionsThe women’s overall satisfaction with intrapartum care was low. Multiple factors influence their satisfaction. Health professionals, policy makers and health administrators should give emphasis to factors that contribute to low satisfaction of women with intrapartum care. They should also strengthen their efforts to deliver quality and easily accessible maternal health service to improve women’s overall satisfaction with the maternal health service.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1428-z) contains supplementary material, which is available to authorized users.

Objective To determine the perinatal outcome of labouring mothers with meconium-stained amniotic fluid (MSAF) compared with clear amniotic fluid at teaching referral hospital in urban Ethiopia. Methods A prospective cohort study was conducted among labouring mothers with meconium-stained amniotic fluid from July 1 to December 30, 2019. Data was collected with pretested structured questionnaires. A Chi-square test used to check statistical associations between variables. Those variables with a p-value of less than 0.05 were selected for cross-tabulation and binary logistic regression. P-value set at 0.05, and 95% CI was used to determine the significance of the association. Relative risk was used to determine the strength and direction of the association. Result Among 438 participants, there where 75(52.1%) primigravida in a stained fluid group compared to112 (38.5%) of the non-stained fluid group. Labour was induced in 25 (17.4%) of the stained fluid group compared to 25(8.6%) of a non-stained fluid group and has a statistically significant association with meconium staining. The stained fluid group was twice more likely to undergo operative delivery compared with a non-stained fluid group. There were more low Apgar scores at birth (36.8% versus 13.2%), birth asphyxias (9% versus 2.4%), neonatal sepsis (1% versus 5.6%), neonatal death (1% versus 9%), and increased admissions to neonatal intensive care unit (6.2% versus 21.5%) among the meconium-stained group as compared to the non-stained group. Meconium aspiration syndrome was seen in 9(6.3%) of the stained fluid group. Conclusion Meconium-stained amniotic fluid is associated with increased frequency of operative delivery, birth asphyxia, neonatal sepsis, and neonatal intensive care unit admissions compared to clear amniotic fluid.

Background Family planning is important in reducing the total fertility rate and subsequent reduction in maternal and infant morbidity and mortality. Postnatal care represents a window of opportunity for education and communication to newly delivered mothers so that they may make appropriate choices on use of family planning. We assessed the barriers to uptake of long-term and permanent family planning methods among immediate post-partum mothers at Saint Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia. MethodsWe did an institution-based cross-sectional study from Jan 1 to June 30, 2017. The 6 months of study were used as strata, with equal allocation and systematic sampling used to select participants in each month. Post-partum mothers were interviewed using pretested semi-structured questionnaires. Data entry and analysis were done using SPSS version 17. Bivariate and multivariate logistic regression were done and adjusted odds ratios (aOR), 95% CIs, and p values set at 0•05 were used to determine statistical significance of the associations. χ² tests were used for statistical analysis of results. Findings 422 post-partum women were interviewed, 192 (45%) of whom started long-term or permanent contraception before discharge. 268 (63%) of women had received counselling on family planning and 241 (57%) got information about contraception from the health facility. Contraceptive counselling (aOR 2•138, 95% CI 0•004-0•331, p=0•003), getting information from the health facility (15•155, 1•848-124•257, p=0•011), and partner support (1•367, 0•175-0•771, p=0•008) were associated with uptake of long-term and permanent contraception. Reasons reported for non-use were fear of side-effects (84 [40%]), opposition from husband (52 [25%]), desire to have more children, lack of awareness, and use of other methods such as lactation amenorrhoea.Interpretation One-to-one counselling with partner involvement would ensure that mothers receive complete information from health facilities, and hence could reduce myths and misperceptions and improve uptake of longterm and permanent methods of contraception.

Very few women were counseled about contraception during prenatal care. Asking about a partner's attitude toward contraceptives and discussing women's fears or worries about contraceptives should be considered during family planning counseling to improve satisfaction and quality of care.